The Cochrane Library and treatment of patent ductus arteriosus: an overview of reviews

2012 ◽  
Vol 7 (4) ◽  
pp. 1185-1195
Author(s):  
JoAnn Harrold ◽  
Thierry Lacaze-Masmonteil ◽  
Lisa Hartling ◽  
Marta Oleszczuk
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Cochrane Library ◽  
Overview Of Reviews ◽  
The Cochrane Library ◽  
Patent Ductus

scholarly journals O35: THE MANAGEMENT OF PATENT DUCTUS ARTERIOSUS IN LOW BIRTH WEIGHT AND PREMATURE NEONATES: WHO, WHAT, WHEN AND HOW?

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
A Asif ◽  
A Parry
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Outcome Measures ◽  
Conservative Management ◽  
Ductus Arteriosus ◽  
Morbidity And Mortality ◽  
Prophylactic Surgery ◽  
Cochrane Library ◽  
Patent Ductus

Abstract Objectives The management of patent ductus arteriosus (PDA) in neonates is a contentious issue with variations between many centres. Does timing PDA management prophylactically, fare better than waiting for haemodynamic compromise? Are medical approaches safer and more effecitve than an interventional approach? How should medical or surgical interventions be approached? Should clinicians intervene at all? This review aims to navigate through the current literature. Method Keywords "Patent ductus arteriosus", "neonate", "premature", "preterm" and "low birth weight" were searched on PubMed, the Cochrane Library and Medline. Referenced articles were also included. Outcome measures such as time to closure, rate of closure, morbidity and mortality were observed. Result Studies observing conservative management showed that PDAs close spontaneously in up to 73%. Complication rates in conservative management compared to indomethacin use were similar, with conservative measures taking longer to reach closure. Indomethacin was shown to have better outcomes when used prophylactically compared to symptomatic cases. However, paracetamol and oral ibuprofen was shown to be safer than indomethacin in symptomatic patients with less renal and gastrointestinal effects. Successful medical management was demonstrated to be dependent on ductal diameter and gestational age. Outcomes following prophylactic surgery were similar to those undergoing conservative management. Morbidity and mortality were similar in those undergoing percutaneous occlusion and open ligation. Conclusion Many studies were observational, retrospective, single-centre studies and had not reported important outcome measures. Robust evidence from randomised, multi-centre studies are needed, as well as studies comparing treatment disciplines. Future studies should look to report long-term outcome measures. Take-home message Despite the range of studies meta-analyses available, there is a lack of robust and definitive evidence out there to suggest when and how to approach a PDA in premature/low-birthweight neonates which is reflected in the heterogeneity of management options for PDA patients between different centres. Observational studies show that conservative management, management using paracetamol and an interventional approach (either thoracotomy or endovascular) are all viable options, however the lack of randomised, interventional studies fail to show which method is superior.

scholarly journals Pharmacological treatment strategies for neonates with patent ductus arteriosus: a systematic review

2019 ◽  
Vol 59 (5) ◽  
pp. 229-36
Author(s):  
Oliver Emmanuel Yausep ◽  
Adhi Teguh Perma Iskandar
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Adverse Events ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Patent Ductus

Background Patent ductus arteriosus (PDA) has a variety of treatment options, ranging from pharmacologic, with nonsteroidal anti-inflammatory drugs (NSAIDs) as first line therapy, to surgical ligation. However, treatment with NSAIDs is associated with severe side effects as well as many contraindications. Paracetamol is a non-classic NSAID with the prospect of fewer side effects compared to other NSAID counterparts. Objectives To compare the efficacy and safety of paracetamol to ibuprofen or indomethacin for neonates with PDA by systematic review of the literature. Methods Our literature search was conducted on four databases: PubMed, Scopus, Ovid, and The Cochrane Library, to find studies that compared paracetamol to ibuprofen or indomethacin in neonates with PDA. Articles were selected based on pre-set eligibility criteria. Outcomes extracted from each study included PDA closure rates as well as adverse events rates. Results Seven randomized controlled trials (RCTs) were included in this study. Five compared paracetamol to ibuprofen and one used indomethacin as a control. The studies were of good quality, with several variations in methodology. All trials reported similar closure rates of paracetamol compared to ibuprofen or indomethacin. Three studies reported similar rates of adverse events, whereas another three reported safety profiles that favoured paracetamol over ibuprofen. Conclusion Paracetamol has similar efficacy to ibuprofen and indomethacin with regards to rate of PDA closure following a course of treatment. Paracetamol is also reportedly relatively safe in terms of adverse events rates experienced by patients.  

ASSOCIATION OF PATENT DUCTUS ARTERIOSUS SIZE WITH CLINICAL FEATURES AND SHORT-TERM OUTCOMES IN PRETERM INFANTS LESS THAN 34 WEEKS

2020 ◽  
Vol 07 (03) ◽  
pp. 105-108
Author(s):  
Chandrakala Bada Shekharappa ◽  
Edison Albert Balakrishnan Elizabeth ◽  
Bharathi Balachander
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Clinical Features ◽  
Ductus Arteriosus ◽  
Short Term ◽  
Patent Ductus

Acetmainophen Effect on Prostaglandin E2; A Mechanism for Patent Ductus Arteriosus Closure

2017 ◽  
Author(s):  
Matthew F Halliday ◽  
Shelly-Ann Williams ◽  
John E. Baatz ◽  
James Kiger ◽  
Perry Halushka ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Prostaglandin E2 ◽  
Ductus Arteriosus ◽  
Patent Ductus Arteriosus Closure ◽  
Patent Ductus
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